BMC Health Services Research最新文献

{"title":"Challenges of ICT use for nurse-patient communication in Portugal: a mixed methods research.","authors":"Marlene Peres, Raquel Simões de Almeida, António Moreira","doi":"10.1186/s12913-025-12977-2","DOIUrl":"10.1186/s12913-025-12977-2","url":null,"abstract":"<p><strong>Background: </strong>The future of digital health holds enormous potential to improve communication with patients and optimize the delivery of care. The current study aims to answer the central question of which knowledge, skills, and competencies in the use of Information and Communication Technologies (ICT), health professionals should develop to promote efficient remote communication processes with patients.</p><p><strong>Methods: </strong>A mixed-method approach was used for data collection, combining an online survey with semi-structured interviews. The study was structured into four key phases/question groups: professional context, practices related to the use of ICT in patient communication, training needs, and other relevant information. Qualitative data from open-ended responses were analysed using thematic analysis and triangulated with quantitative findings where applicable. The target population consisted of nursing professionals with patient care experience. The survey was distributed electronically, with 194 nurses fully or partially completing the questionnaire. Additionally, 24 interviews were conducted.</p><p><strong>Results: </strong>The data shows that around 25.85% of professionals do not establish distance communication and 95.4% do not use telehealth. Telephone and cellular contact are the most used means of communication with patients (62.60%). Despite the predominance of face-to-face care, 62.5% stated that they do not experience difficulties or concerns, recognizing ICT as an increasingly integrated and advantageous tool for remote communication. Most professionals (80.1%) believe that there should be more training and courses in digital communication with patients and the use of ICT in healthcare, to address gaps in academic training. The growth of telemedicine and the digitalization of healthcare services reinforce the need for continuous professional training in this area.</p><p><strong>Conclusions: </strong>Most professionals have a positive perception of the opportunities created by emerging technologies, but they also express concerns about the ethical, social, safety and technical challenges that need to be addressed. The introduction of mandatory ICT courses in academic education and the implementation of continuous training are essential to prepare professionals for the challenges of telehealth and digital communication in healthcare. They emphasize the need for a well-structured digital transition, ensuring that technologies complement healthcare rather than replace human care.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"944"},"PeriodicalIF":2.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using cluster analysis to identify the health literacy strengths and challenges of people living with motor neurone disease in Australia.","authors":"Arabelle Douglas, Maryanne McPhee, Fiona Fisher, Christina Cheng, Anjali Henders, Laura Ziser, Julie C Stout, Matthew C Kiernan, Richard Osborne, Susan Mathers","doi":"10.1186/s12913-025-12998-x","DOIUrl":"10.1186/s12913-025-12998-x","url":null,"abstract":"<p><strong>Background: </strong>There is growing appreciation of the role health literacy plays in population health and health care design. Health literacy encompasses an individual's capacity to manage their health and the responsiveness of the health system. Our aim was to identify the health literacy strengths and challenges in an Australian cohort living with motor neurone disease (MND), including both people living with the disease and their carers.</p><p><strong>Methods: </strong>This study used the Health Literacy Questionnaire and eHealth Literacy Questionnaire for health literacy assessment. Using a secure online platform, an anonymous survey was disseminated which included demographic data and clinical measurements. Descriptive statistical analysis and cluster analysis were employed to describe the sample and to identify different health literacy patterns in subgroups of people living with MND and their carers.</p><p><strong>Results: </strong>A total of 227 people participated (171 people living with MND and 56 carers). Cluster analysis generated fifteen cluster profiles for the cohort living with MND and seven cluster profiles for carers. The variability and potential significance of patterns of health literacy strengths and challenges within the MND community are described. There was extensive diversity within the sampled population, with a mix of sociodemographic backgrounds across each cluster profile.</p><p><strong>Conclusions: </strong>The health literacy cluster profiles created from this study provide insight into the full spectrum of where the challenges and strengths exist for individuals and subgroups of people managing this fatal disease. The results from this study pave the way for generating system wide interventions that address health literacy diversity, to create more enabling health care environments for all those affected by MND.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"942"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacists' knowledge, attitudes, and practices toward preventing congenital disabilities: a cross sectional study in Saudi Arabia.","authors":"Fahad S Alshehri, Nasser M Alorfi, Ahmed M Ashour, Ammar Abdulrahman Jairoun, Saad M Wali, Mohammed M Aldurdunji, Shaker T Alsharif, Reem Hasaballah Alhasani, Nasser M Aldekhail, Abdullah S Alshehri, Alqassem Y Hakami","doi":"10.1186/s12913-025-13098-6","DOIUrl":"10.1186/s12913-025-13098-6","url":null,"abstract":"<p><strong>Background: </strong>Congenital impairments, arising from a range of genetic, environmental, dietary, and teratogenic factors, are a significant public health concern. Pharmacists play a key role in preventing these conditions by ensuring pharmaceutical safety and providing maternal health education. However, there is limited research on the knowledge, attitudes, and practices of pharmacists in Saudi Arabia regarding the causes of congenital impairments.</p><p><strong>Objectives: </strong>This study aimed to assess pharmacists' awareness, perceptions, and practices related to these factors and identify key demographic influences on their knowledge and engagement.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among licensed pharmacists based in Saudi Arabia, including those working in clinical, academic, hospital, and community settings. A standardized and validated questionnaire comprising 30 items divided across knowledge, attitude, and practice domains was used to assess pharmacists' perspectives. The data were analyzed using descriptive statistics and multivariate linear regression to identify the key demographic factors associated with knowledge, attitudes, and practice scores.</p><p><strong>Results: </strong>The study included a total of 424 pharmacists, the majority of whom held a master's degree (60.4%), were male (73.6%), and were aged between 25 and 34 years old (41.5%). Hospital pharmacists achieved significantly higher knowledge (4.39 ± 1.48, P < 0.001), attitude (29.20 ± 5.49, P = 0.000), and practice (33.16 ± 6.84, P < 0.001) scores than community pharmacists. The knowledge gaps identified concerned the impact of environmental contaminants (28.5%) and maternal obesity (30.9%) on fetal development. However, pharmacists showed strong positive attitudes toward preventive measures, with 49.1% supporting increased training and 52.8% endorsing genetic screening as essential interventions.</p><p><strong>Conclusion: </strong>The study highlights significant gaps in pharmacists' understanding and practice concerning congenital impairments, particularly regarding lifestyle and environmental risk factors. Despite strong support for pharmacist training, participation in public health campaigns and patient counseling on teratogenic risks remains limited. To enhance congenital disability prevention efforts in Saudi Arabia, these findings emphasize the need for improved pharmacist knowledge, structured training programs, and more extensive integration of pharmacists within maternal healthcare teams.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"939"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How communitization begets and endures sarkarikaran: a witnessed history of community action for health in India's national rural health mission.","authors":"Devaki Nambiar, Neymat Chadha","doi":"10.1186/s12913-025-13058-0","DOIUrl":"10.1186/s12913-025-13058-0","url":null,"abstract":"<p><p>The legacy of Community Action for Health (CAH) in India traces back to the global momentum for primary health care galvanized by the Alma Ata Declaration and post-World War II social movements. In 2024, the World Health Assembly endorsed a resolution on institutionalising CAH and other forms of social participation as a core pillar of health reform. The Indian experience of institutionalising CAH under its erstwhile National Rural Health Mission offers an example of sustained national-scale implementations of CAH globally, yet its lessons-both successes and blind spots-remain under-analysed. This paper aims to fill that gap by critically examining the trajectory of CAH since 2005 and exploring its implications for the operationalization of the SPH Resolution. In 2021, two virtual Witness Seminars and four in-depth interviews were conducted with leaders of Civil Society Organizations (CSOs), program implementers, and policy decision-makers involved in the institutionalization of Community Action for Health (CAH) under the National Rural Health Mission (NRHM). Participants included. Seminars and interviews explored key events, actors, processes, and contextual factors that shaped the evolution of CAH. All sessions were fully transcribed and analysed using ATLAS.ti (version 22). Our analysis of the evolution of CAH in India suggests four phases - leading to and flowing away from governmentality. While initially communitization involved collaborative dialogue, debate and system redesign, pilots of CAH rolled out across Indian states with varying strategies, ownership, and stakeholdership. Roles of community began to shift into that of agents and providers as part of \"sarkarikaran\" or governmentalization of community processes. A final phase suggests that like flowing water, CAH may continue to reconfigure state-society relations in the wake of emerging challenges, less formalised, more embedded interactions. This suggests that institutionalising, standardizing and centralising CAH is neither lasting, nor desirable.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"940"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographers' involvement in MRI research: factors driving and hindering participation in Sub-Saharan Africa.","authors":"Christian Ven Emery, Adesola Adepoju, Abdul Nashirudeen Mumuni, Bernard Amedzoame, Sekinat Zurakat-Aderibigbe, Elizabeth Balogun, Jackline Thairu, Eric Akpabli, Iris Asllani, Klenam Dzefi-Tettey, Godwin Ogbole","doi":"10.1186/s12913-025-13081-1","DOIUrl":"10.1186/s12913-025-13081-1","url":null,"abstract":"<p><strong>Introduction: </strong>Magnetic resonance imaging (MRI) holds transformative potential for advancing clinical practice and professional growth in radiography. However, African radiographers face limited opportunities to engage in evidence-based practice through research. This study evaluates the level of MRI research engagement among, the factors motivating their participation, and the barriers impeding their progress.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 312 radiographers recruited through convenience sampling. Participants completed a self-administered online questionnaire via Google Forms. Due to the open online distribution through professional networks, a response rate could not be precisely calculated. Descriptive and inferential statistical analyses assessed associations between categorical variables, with a significance threshold of p < 0.05.</p><p><strong>Results: </strong>Of the 312 participants, 21.2% reported prior involvement in MRI research. Engagement was higher among radiographers with postgraduate qualifications (39.6%). Also, radiographers in academic roles were 47.4%, those working in both public and private facilities were 32.3%, and those with access to MRI scanners were 25.0%. Motivating factors included peer support (10.3%), membership in research groups (8.7%), research training (8.7%), and mentorship (8.3%). A significant association was observed between MRI scanner availability and interest in research (p = 0.0001). Barriers included insufficient funding (68.3%), time constraints (51.9%), and inadequate research skills (37.2%).</p><p><strong>Conclusion: </strong>Despite a strong interest in MRI research, the surveyed cohort of radiographers from the 18 Sub-Saharan African countries encounter significant barriers, resulting in low engagement levels. Addressing these challenges through targeted training, mentorship, and the creation of dedicated research roles is essential to fostering evidence-based practice and innovation in radiography.</p><p><strong>Implications for practice: </strong>The findings emphasize establishing protected research time, fostering regional and international collaborations, and implementing structured skill development programs. Such measures can enhance research activity, promote innovation, and improve patient care and diagnostic outcomes in African radiography practice.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"941"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of medication reviews to optimize the use of medications in Swiss nursing homes: a mixed-methods study.","authors":"Stephanie Mena, Julie Dubois, Marie Schneider, Anne Niquille","doi":"10.1186/s12913-025-13042-8","DOIUrl":"10.1186/s12913-025-13042-8","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy, can cause drug related problems (DRPs), including the use of potentially inappropriate medications (PIMs). Services such as medication reviews (MRs) have been initiated to address DRPs and PIMs, but their implementation remains underreported. In 2021 and 2022, a pilot project was developed with the goal of reorganizing the care of a pharmacy service to introduce a patient-centered, interprofessional MR service. The project, Medication Reviews in Nursing Homes (MRNH), took place in 10 Swiss nursing homes (NHs). The aim of this study was to evaluate the implementation and impact of the MRNH project in order to gain a better understanding of the processes involved in implementing MR in nursing homes.</p><p><strong>Methods: </strong>This observational study followed a Type 3 hybrid implementation-effectiveness design using quantitative and qualitative analyses. Relevant implementation outcomes were defined through the Framework for the Implementation of Services in Pharmacy (FISpH) and the Reach, Effectiveness, Adoption, Implementation, Maintenance RE-AIM framework. Data were collected via questionnaires, focus groups and administrative records. The study evaluates factors and strategies related to the implementation of MRs and assesses the impact of MRs based on the proportion of resolved DRPs at a four-month follow-up.</p><p><strong>Results: </strong>The target was for each NH to perform MRs for 10% of the NHs population. Seven of the NHs achieved this goal, which results in 55 MRs presented of a theoretical total of 75. Following interprofessional team discussions, treatment plans including 145 modifications were created, of which 128 were effectively implemented. As 120 of them were maintained at follow-up, MRs performed lead to a 83% of a partial or complete resolution of the DRPs detected (CI: 74.5-90.7%; 43 MRs). Implementation strategies were considered as useful by HCPs, including pharmacist training, clinical support and audit & feedback and defining their own sub-process. Seven of 10 participating NHs continued MRs after MRNH.</p><p><strong>Conclusions: </strong>The implementation of MRs in NHs was successful in seven of the 10 participating NHs. The service was considered feasible and accepted, and its dissemination was recommended by the participating healthcare professionals. The results of the study support the decision of the regional health department to extend the service to more NHs and may help identify strategies to further sustain its implementation.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"943"},"PeriodicalIF":3.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring integrated care for children with cerebral palsy: a stakeholder analysis.","authors":"Silje Askeland, Veslemøy Guise, Karina Aase, Maren Kristine Raknes Sogstad","doi":"10.1186/s12913-025-13015-x","DOIUrl":"10.1186/s12913-025-13015-x","url":null,"abstract":"<p><strong>Background: </strong>Children with cerebral palsy (CP) and their families need coordinated services. Accordingly, integrated care models have been introduced as the standard for service provision. However, situations with coordination and collaboration challenges occur leading to fragmented services that do not meet the care needs of children and families. This study aimed to identify stakeholders involved in the care and follow-up of children and their families and explore their roles, responsibilities, and relationships to inform the improvement of integrated care for children with CP.</p><p><strong>Methods: </strong>A stakeholder analysis was conducted based on interviews with children, parents, and service providers; observations in multidisciplinary coordination meetings; and a review of documents. Six families with a child aged between 8 and 12 years with a primary diagnosis of CP participated. Relevant service providers were identified through family interviews and were invited to individual or focus group interviews.</p><p><strong>Results: </strong>The results identified 42 stakeholders categorized into 14 groups offering healthcare, educational, social, and family support services. Stakeholders become involved in the families' long-term care at different times and provide services within various time spans according to specific emerging challenges. Stakeholders' responsibilities include diagnosing and referring patients, providing short-term treatment, and providing long-term care. Additionally, responsibilities can be overlapping and unclear, and the involved stakeholders operate under different regulations and institutional contexts, leading to gaps in patient follow-up. Relationships between the stakeholders vary from full integration to no contact.</p><p><strong>Conclusion: </strong>Long-term care for children with CP and their families is complex, involving numerous stakeholders across various sectors, governed by regulations within different institutional contexts, challenging integrated care. Stakeholders' affiliation with different sectors and their varying roles has the potential to contribute to a holistic approach. However, without clear guidance this seems hard to achieve, which may lead to a lack of collective understanding and unmet needs for children and families. There is still a need for further research on collaborative experiences among children, families, and service providers, and their impact on integrated services.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"936"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating policy guidelines: a multiple case study of disease prevention in Sweden.","authors":"Mattias Elg, Elin Wihlborg, Malin Wiger","doi":"10.1186/s12913-025-13068-y","DOIUrl":"10.1186/s12913-025-13068-y","url":null,"abstract":"<p><strong>Background: </strong>There is a growing need for new knowledge about healthcare policy implementation that is relevant to both researchers and practitioners. Many policy initiatives fail due to insufficient coordination between different system levels and conflicting agendas among various actors. This paper aims to propose and illustrate an analytical framework using a multilevel-multilogic framework. This framework helps reveal the combined challenges encountered when implementing policies within public healthcare systems.</p><p><strong>Methods: </strong>A multiple case study was conducted, focusing on the implementation of disease prevention guidelines in four Swedish healthcare regions. These regions were purposefully selected to represent diverse contexts and conditions that could influence policy translation. A total of 28 respondents across the four regions were interviewed, representing different system levels and institutional logics. The qualitative analysis identified connections between actors, settings, and policies, and explored how policy translation varied-from strong to weak, or even interrupted-as it moved from policy development to clinical practice.</p><p><strong>Results: </strong>We developed a theoretical and empirical understanding of policy translation processes, tracking how evidence-based national guidelines for disease prevention methods (DPMs) moved through regional administrative systems into clinical practice. The analysis focused on four main themes: the gradual translation and reinterpretation of policy objectives, the impact of shifting policy priorities, the facilitating role of technology in translation processes, and the ways policy became embedded into everyday clinical routines.</p><p><strong>Conclusions: </strong>Policy guidelines are implemented through a stepwise translation process, first being adopted and adapted within healthcare administrative systems via political and administrative activities, and then integrated into clinical practice. Within the multilevel-multilogic framework, each system level or logic has the potential to adapt, alter, delay, or even block the intended policy. Actions taken early in the translation process significantly affect the outcomes of subsequent stages.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"938"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education of medical caregivers in Poland: areas requiring improvement - mixed-method research.","authors":"Magdalena Krysińska-Pisarek, Katarzyna Domosławska-Żylińska, Piotr Tyszko","doi":"10.1186/s12913-025-13011-1","DOIUrl":"10.1186/s12913-025-13011-1","url":null,"abstract":"<p><strong>Background: </strong>Demographic changes associated with an ageing population, combined with the shortage of nursing personnel in Poland, have led to the introduction of a distinct new medical profession-the medical caregiver-which is separate from the nursing profession and has been officially included in the national classification of professions and specialties. In light of the demands of this role, a study was conducted with the primary objective of analysing educational outcomes and identifying areas requiring improvement in both theoretical knowledge and practical skills within the educational process for medical caregivers.</p><p><strong>Methods: </strong>Convergent parallel mixed-methods design was used, with quantitative (Computer-Assisted Web Interview, CAWI and paper questionnaire)and qualitative components (3 mini Focus Group Interview, FGI) conducted concurrently and results integrated. Coding disagreements were resolved through discussion among the three researchers until consensus was reached. A total of 840 surveys were included in the analysis. Statistical analyses were conducted using the IBM SPSS Statistics 26.0 statistical package, STATISTICA version 12.0, and Excel spreadsheet software.</p><p><strong>Results: </strong>Key areas of education identified as needing further development included: the fundamentals of care for ill and dependent individuals, essential aspects of medical care, personal and social competencies, health and safety at work, planning and performing hygiene and care activities for ill and dependent individuals and performing selected tasks tailored to the needs of individuals with dementia. Both survey respondents and FGI participants consistently identified insufficient training in practical skills and soft skills.</p><p><strong>Conclusions: </strong>Our results explicitly identify specific training gaps in sign language, practical clinical skills, and stress management, supporting our recommendations for targeted improvements in these areas. Implementing these curriculum improvements would require coordinated efforts between educational institutions and healthcare employers.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"935"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher levels of person-centred care are associated with lower levels of stress of conscience in hospital and municipal care: cross-sectional findings from the PCC@Work project.","authors":"Kristoffer Gustavsson, Andreas Fors, Cornelia van Diepen, Malin Axelsson, Monica Bertilsson, Angela Bångsbo, Gunnel Hensing, Qarin Lood","doi":"10.1186/s12913-025-13077-x","DOIUrl":"10.1186/s12913-025-13077-x","url":null,"abstract":"<p><strong>Background: </strong>Stress of conscience is common in health and social care, being associated with adverse health consequences, staff turnover, and poor care quality. Person-centred care (PCC), an ethical approach to care with potential to reduce stress of conscience, has been little explored across healthcare settings. This study assesses the association between perceived PCC and stress of conscience among health and social care professionals in hospital and municipal care settings.</p><p><strong>Methods: </strong>A web survey was sent to 11,554 health and social care professionals employed in hospital and municipal care settings in western Sweden. It yielded 2123 responses, and cross-sectional analyses were performed with data from 1671 professionals. The Person-Centred Care Assessment Tool was used to measure PCC, for both the full scale (P-CAT) and its subscales \"Extent of Personalising Care\" (EPC) and \"Organisational and Environmental Support\" (OES). The Stress of Conscience Questionnaire (SCQ) was used to measure the outcome stress of conscience. Bivariate correlations and linear regressions were used to analyse the data.</p><p><strong>Results: </strong>The bivariate correlations were significant and negative for P-CAT (r_s = - 0.399, p < 0.01), EPC (r_s = - 0.239, p < 0.01), and OES (r_s = - 0.482, p < 0.01) with SCQ. When adjusted for covariates, multivariate linear regressions identified negative associations for P-CAT (B = - 1.16, 95% CI - 1.33, - 0.99, p < 0.001), EPC (B = - 0.8, 95% CI - 1.04, - 0.56, p < 0.001), and OES (B = - 3.14, 95% CI - 3.52, - 2.78, p < 0.001) with SCQ, indicating that as the scores of P-CAT and its subscales increase, the SCQ score decreases.</p><p><strong>Conclusions: </strong>Our findings revealed that hospital and municipal health and social care professionals who perceived higher levels of PCC also perceived lower levels of stress of conscience. Considering the increased focus on PCC internationally, the results are relevant, as PCC might be one possible approach to mitigate stress of conscience. More knowledge of EPC and OES in relation to stress of conscience could be important for improved and better-targeted PCC implementation efforts.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"937"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}